Over the past 18 years, the influence of opioids has taken hold in the United States and its grip has only gotten tighter as each year passes, the epidemic has resulted in the deaths of tens of thousands of American citizens. Opioids is a blanket term to refer to heroin, prescription drugs such as oxycodone and morphine and synthetic drugs like the newly popular fentanyl. While drugs like heroin have received widespread media attention since the “Just Say No” Reagan era, powerful pain-reducing prescription and synthetic drugs have become vastly more popular in the U.S., affecting far more people than heroin, especially among younger people. According to the National Institutes of Health, more than 2 million Americans have an opioid use disorder while the Department of Health and Human Services estimates that over 11 million more people misuse opioids by taking medication longer and in higher doses than recommended.
Since the rise of opioids in the late 1990s, the country has seen a major negative economic impact that is due to the increased usage and overdoses from these drugs. The human and economic cost of these drugs has put the epidemic in the public eye and the opioid crisis has become a point of national concern, giving Republicans and Democrats one political point that they can agree on. Despite the bipartisan efforts to find a solution to the problem, no real impact on the epidemic has been seen.
The Human Cost of the Opioid Epidemic
Over the past two decades, the opioid crisis has reached peak levels of severity and one research institute estimates that the toll will continue to rise over the next two years.
The Center for Disease Control found that from 2016 to 2017, drug overdoses in the country rose by 22 percent from almost 53,000 to just over 64,000. The spike in drug overdose deaths from 2016 to 2017 is minuscule when you look at the larger picture that has been taken over the past couple decades, or even just the past five years.
The National Institute on Drug Abuse found that since 2013, annual opioid overdose deaths have risen from just over 2,500 to almost 30,000. This represents an increase of 1200 percent in just five years.
While all other drugs except for methadone has seen increases as well, none have been as severe as opioids, as seen here.
"I'm not prone to dramatic statements," Robert Anderson, chief of the mortality statistics branch at the National Center for Health Statistics, told NPR in 2017. "But I think we should be really alarmed. The drug overdose problem is a public health problem and it needs to be addressed. We need to get a handle on it."
The opioid epidemic is so severe it may have even had an effect on the life expectancy in the country which has fallen over the past two years. The last time the country saw the life expectancy rate drop in consecutive years was in the 1960s.
According to the White House, there have been over 300,000 deaths due to opioids since 2000 and the HHS says that over 130 people die every day due to opioid-related overdoses.
Estimating the Economic Impact
While the number of deaths can be researched and calculated, the emotional impact that these deaths have on families is impossible to itemize. Something that is quantifiable is how these deaths have influenced the country’s economy.
The economic report, done by Altarum, a nonprofit health research institute, made it clear that the report would focus solely on the economic aspect of the problem.
“This analysis is concerned with the economic cost of the opioid crisis, but the human cost—the emotional toll on individuals with a use disorder, and that on their families and communities is substantial and vitally important to any complete analysis of the crisis. We are not able to quantify those additional costs in our analysis due to the inherent difficulty of estimating them,” the report said.
Altarum’s 2018 report found that since 2001 the opioid crisis has cost the country over $1 trillion, with the costs gradually rising over time. In fact, $115 billion in costs came in 2017 alone. That cost is estimated to rise by another $500 billion by 2020 with the gradual increase spiking to almost $200 billion in annual costs.
The $500 billion figure is a warning that if something is not done to reduce the growing impact of opioids, the country could be looking at an even worse situation.
Other cost estimates done by the White House’s Council of Economic Advisors said that in 2015 the cost may have even reached over $600 billion.
The American Enterprise Institute also took a look at the cost that the opioid crisis has been having on the country by looking at states and countries specifically rather than the nation as a whole.
“The types of costs attributable to opioid abuse – health care costs, criminal justice costs, and lost productivity, for example – are fairly well understood, as is the economic impact of the crisis at the national level. However, the economic burden of the opioid epidemic is unevenly distributed across the country, with many communities especially hard hit,” The AEI report said.
The report found that certain states and counties were more harshly impacted by the costs of the opioid crisis due to a number of variables. The report said that the highest total costs were in counties in Kentucky and West Virginia.
While the actual costs may be a bit murky, one thing is for certain: the opioid crisis has had a clear, negative effect on the United States economy.
The costs of this comes in the form of lost wages. Altarum indicates that the loss of productivity and wages results in a loss of about $800,000 per individual. This number is then compounded by other factors including the loss of tax revenue to all levels of government.
In 2017, Princeton economist Alan Krueger suggested that increases in opioid prescriptions from 1999 to 2015 could account for part of a 20 percent drop in male labor force participation and 25 percent decrease in female labor force participation.
“Labor force participation is lower and fell more in the 2000s in areas of the U.S. that have a higher volume of opioid medication prescribed per capita than in other areas,” the study said. “The opioid crisis and depressed labor force participation are now intertwined in many parts of the U.S.”
The lack of productivity also puts a dent in the profits of the private sector, negatively affecting employer profits.
The rising economic impact of the opioid crisis is due not only to the increased usage of opioids over nearly the past two decades but also the fact that the epidemic has begun to transition from older people to younger people which means more productivity and, therefore, more wages are lost with each death.
The increasing prominence of the opioid epidemic is also costly to hospitals and health care clinics that provide services to stabilize individuals following an overdose.
Altarum estimates that from 2001 to 2017, the health care costs of the opioid crisis has reached $215.7 billion.
Fighting the Crisis
While the opioid problem is still having disastrous effects across the country, the U.S. Government has tried to take steps and fight the ongoing crisis, one method is the implementation of more opioid treatment programs.
Both President Obama and President Trump have given time and resources in an attempt to crack down on the problem. Obama’s stance on the issue came later in his presidency when the problem began to become more visible.
However, both presidents proposed to increase funding to health services to try and fight the issue.
The opioid epidemic has become a talking point for President Trump and he has proposed budget changes, new commissions and declared the crisis a national public health emergency in an attempt to address the problem.
In March of 2017, President Trump signed an executive order to establish the President’s Commission on Combating Drug Addiction and the Opioid Crisis.
“I made a promise to the American people to take action to keep drugs from pouring into our country and to help those who have been so badly affected by them,” Trump said. “This is an epidemic that knows no boundaries and shows no mercy, and we will show great compassion and resolve as we work together on this important issue.”
However, the commission received some negative attention and was eventually disbanded in late 2017 after publishing their final report.
“It is time we all say what we know is true: addiction is a disease. However, we do not treat addiction in this country like we treat other diseases. Neither government nor the private sector has committed the support necessary for research, prevention, and treatment like we do for other diseases,” the opening letter of the final report said.
One more recent example is the Trump administration’s establishment of the CrisisNextDoor.gov website in March.
The website is an outlet for people who have previously struggled with opioid addiction to tell their stories, an attempt to fight the negative stereotypes and stigmas that surround the drug problem.
“Tragically, for many of our fellow citizens, the opioid crisis has replaced the American Dream with the nightmare of addiction,” The President has said regarding the crisis. “That is why my administration has declared
The website features personal testimonies from individuals around the country about how the opioid crisis has affected them.
Stories from famous individuals about how their lives have been affected due to personal use or use by family are featured on the front page as well, including baseball legend Darryl Strawberry, political commentator and serving U.S. Surgeon General Jerome Adams..
“Addiction is powerful. It rules and reigns over a life. It did for [my life] for many years, I sit here today free and liberated and I just want to encourage people that hope it’s possible. It’s truly about people helping people,” Strawberry said in his online video.
The CDC has launched a similar campaign called Rx Awareness in order to spread awareness about the rising use of opioids. Rx Awareness focuses on using advertising, social media and radio to tell the stories of those who have struggled with opioid addiction.
Besides efforts to increase communication on the issue, the government has also taken steps to try and actively fight it.
The President’s proposed 2019 budget included increased funding requests to multiple health services and resources. This included a $10 billion request in new funding for the Department of Health and Human Services to combat the problem and fight the epidemic.
In April, the NIH began the HEAL Initiative and was given $500 million from Congress. The mission of the initiative is to improve treatments for opioid addiction and misuse and to research chronic pain in hopes to test other methods of treatment and therapy for pain to provide a substitute for opioids.
In an interview with USA Today, The NIH Director, Dr. Francis Collins, agreed with the notion that opioid addiction is a disease.
“We know this is a brain disease," Collins said. "Any idea that this is just willpower and you ought to be able to get over it is completely contrary to what we know on the basis of strongest medical evidence."
While efforts have been taken in order to curtail the opioid crisis that has impacted millions of lives over the past 18 years, major results are yet to be seen and the road to a permanent, effective solution is still a long one.
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